Florida and U.S. Virgin Islands Part B POE-AG minutes – November 21, 2024

Jurisdiction N

Medicare Part B

November 21, 2024

Welcome and introductions

Janice Mumma, Supervisor, welcomed the members and reviewed current committee guidelines. 

Janice advised the purpose of the POE AG is to assist the contactor in the creation, implementation, and review of provider education events. We conduct this meeting to allow provider feedback on training topics, provider education materials, dates, and times of provider education events. 

Prior quarter activities

The group discussed the attendance at the prior webinars. The top and low attended prior quarter activities were reviewed, and feedback was requested.

Positive feedback was received on the webinars that we are hosting.

A comment was received saying that they were surprised at the low attendance. Janice asked for any suggestions on how to get the word out on our education and how we can get our attendance numbers up. Any suggestions can be sent to Janice for consideration. Janice also advised that we do record a lot of our webinars, so if you are unable to attend, you are able to get the information out on our website. 

Next quarter activities

The upcoming activities for the remainder of November 2024 were reviewed. December calendar is posted, and the January 2025 calendar is in development. A comment was received advising that there is a major AMA conference during November, and it was asked if we could consider not holding any major events during this time frame. Janice advised that we would take this into consideration and try to block of these dates for 2025 events. 

CMS activities

Janice reviewed the CMS website homepage, search feature, CMS Newsroom Press Release, and 2024 Transmittals. Please email Janice Mumma at Janice.mumma@novitas-solutions.com, if you would like any additional information or would like to see education regarding any of the items listed on any of the pages discussed.  

Comprehensive error rate testing (CERT)

The CERT information on the First Coast website was reviewed. First Coast has compiled resources and developed checklists to help guide you when responding to CERT documentation requests. The CERT information is used to build many of the POE presentations and articles. Healthcare providers retain responsibility to submit complete and accurate documentation upon request to Medicare. Additionally, there is an all-MAC CERT education task force. This team has developed a lot of educational articles, booklets, and videos to help you through the CERT process. You can access these materials on the CERT center of our website.

StayConnected workshops

We will continue to offer the StayConnected workshop series in 2024. StayConnected workshops consist of multiple webinars over a one-week span that are topic specific. We will be offering the New Provider workshop in December.

Social media 

First Coast is active in social media. LinkedIn and YouTube are live. Subscribe today and please promote these social media tools to your colleagues. 

On-Demand training

First Coast has a wide array of on-demand learning resources. These resources are intended for you to participate in Medicare education at your own pace, on your schedule. Check out recent postings. 

How to Prepare for Fiscal Year (FY)/Calendar Year (CY) 2025

The end of the year is coming, which means FY/CY 2025 is on the horizon. For final rules such as the Medicare Physician Fee Schedule, you can access the CMS Newsroom for updates. Make sure you subscribe to the CMS MLN Connects Newsletter to stay up to date on all Medicare news. 

Medical Review - Additional Documentation Request (ADR)

Additional Documentation Request denials are direct results of a pre-pay review. Ensure your contact information is current with the Medicare Administrative Contractor (MAC). The CERT additional documentation request (ADR) letters are sent to the provider’s address on file with the MAC found under the “Medical Record Corresponding Mailing Address" in PECOS. Search “ADR” for instructions on the methods to submit the requested documentation.

Important Update for Sole Owner Groups Submitting Revalidation Applications

Effective August 14, 2024, you must submit a CMS-855B application to revalidate the groups enrollment. Submission of a CMS-855I application is no longer required and will be returned if submitted via PECOS. For more information, visit our Provider Enrollment Center. 

Discuss Preventive Services with Your Patient 

Providers play a crucial role in promoting, providing, and educating Medicare patients about potentially life-saving preventive services and screenings. Ensure your Medicare patients take advantage of Medicare-covered preventive services. Medicare covers many preventive services for eligible patients and there are some screenings and shots that are at little or no cost to Medicare beneficiaries. Talk with your patient to explain the new screenings that were added. Learn more about billing for Medicare-covered preventive services on the CMS website.

Interactive Preventive Services Tool

CMS has a great tool online for preventive services. When this tool is accessed, click on the preventive service and you’ll find everything you need to know about billing that particular service. If you see a T denoted, then that indicates the service may be billed as telehealth.

Influenza Vaccine Payment Allowances – Amount Update for 2024 – 2025 Season

A recurring CR was released that notifies providers that the payment allowances for the seasonal influenza virus vaccine are available. Allowable amounts are available on the CMS website.

Heart Health

Heart disease is the leading cause of death for men and women, and people of most racial and ethnic groups. Heart disease includes hypertension, coronary artery disease, heart failure, and stroke. Risk factors include overweight, obesity, physical inactivity, diabetes, smoking, high blood pressure, family history, and older age. Medicare covers cardiovascular disease screening tests, and your patients pay nothing if you accept assignment. For more information on heart disease, visit the CMS website. 

Open discussion 

Suggestions on topics, dates and times can be emailed to Janice.Mumma@novitas-solutions.com.

A question was received asking if Medicare has changed the CPT code for telemedicine, and they are receiving conflicting information. Cesar advised that the final rule was finalized earlier this month, and another press release was just recently released. They have not authorized the changes yet, so that may be why we have not issued specific 2025 information yet. The official release will be December 7, but it is posted to the CMS website already.